目的： 研究DC-CIK联合化疗治疗晚期非小细胞肺癌的疗效及安全性。 方法： 选取2008年8月至2010年1月就诊于山西省肿瘤医院的50例Ⅲ~Ⅳ晚期非小细胞肺癌患者，采用DC-CIK联合化疗\[多西他赛(docetaxel)+顺铂(cisplatin)\]为联合治疗组；选取临床资料相近的同期进行单纯化疗（多西他赛+顺铂）的50例Ⅲ~Ⅳ晚期非小细胞肺癌患者为单纯化疗组，比较两组患者治疗后的免疫功能、近期疗效、1年生存率、生活质量，并观察DC-CIK细胞治疗的安全性。 结果: 成功培养患者的DC-CIK细胞，其中的CD3+CD8+、CD3＋CD56+细胞比例较培养前显著提高（P＜0.05）。联合治疗组患者治疗后外周血各T细胞亚群均无明显变化，IFN-γ水平显著升高（P＜0.05）；单纯化疗组患者治疗后外周血CD3+CD4+、CD3+CD8+、CD3-CD56+细胞比例下降（P＜0.05），IL-2、TNF-α水平明显降低 (P＜0.05）。联合治疗组患者的DCR为78.0%，显著高于单纯化疗组的56.0%（P＜0.05）；联合治疗组患者1年生存率为50.0%，与单纯化疗组44.0%的差别无统计学意义（P＞005）。联合治疗组患者的不良反应（包括骨髓抑制、恶心呕吐、周围神经毒性）明显轻于单纯化疗组（P＜0.05），联合治疗组患者治疗后体力、食欲较单纯化疗组改善明显。 结论： 与单纯化疗相比，DC-CIK联合化疗治疗晚期非小细胞肺癌安全、有效，可以提高缓解率，延长生存期，改善患者的生活质量。

Objective : To evaluate the safety and therapeutic effect of dentritic cell (DC)-cytokine induced killer cells (CIKs) combined with chemotherapy in treatment of advanced non-small cell lung cancer (NSCLC) patients. Methods: Fifty patients with advanced NSCLC (stage Ⅲ to Ⅳ), who were admitted to Tumor Hospital of Shanxi Province from August 2008 to January 2010, were treated by DC-CIK combined with chemotherapy (docetaxel+cisplatin) and were taken as the combined treatment group; another fifty advanced NSCLC patients who were treated with chemotherapy alone (docetaxel+cisplatin) during the same period were taken as controls. The immune function, therapeutic effect, 1-year survival, life quality, and side effects were compared between the two groups. Furthermore, the safety and therapeutic effects of DC-CIK therapy were observed. Results: DC-CIK cells from NSCLC patients were successfully induced, the ratios of CD3+CD8+ and CD3＋CD56+ cells in DC-CIK cells were significantly increased after culture (P＜0.05). There were no obvious changes of T cell subsets in the peripheral blood after combined therapy, and the therapy increased IFN-γ level (P<0.05). In the chemotherapy group, the ratios of CD3+CD4+, CD3+CD8+, CD3-CD56+ cells and IL-2, TNF-α levels were significantly decreased after cell culture (P＜0.05); and the ratios of CD3+CD8+, CD3+CD56+ cells in DC-CIK was increased (P＜0.05). The disease control rate (DCR) of combined therapy group was higher than that in chemotherapy group (78.0% vs 56.0%, P<0.05); the 1-year survival rates of combined therapy group and chemotherapy group were 50% and 44%, respectively, showing no significant difference (P>0.05). The combined therapy group had less side effects（including bone marrow suppression, nausea and vomiting, and peripheral nerve toxicity）compared with the control chemotherapy group (P＜0.05). The physical condition and appetite of NSCLC patients in the combined therapy group were better than those in chemotherapy group.Conclusion: Treatment with DC-CIK cells combined with chemotherapy is safe and effective for advanced NSCLC, and it can also improve the remission rate, survival and quality of life of NSCLC patients.

山西省科技厅攻关项目资助（No.051096-2）